ABSTRACT

John Halverson wrote “the cost of excellent weight loss is metabolic risk” (1987). When considering elective surgery, one must weigh the potential benefits against the possible risks. Surgical risks can be divided into two categories. The first category consists of common surgical complications such as wound infections. The second category consists of those risks that are specific to the procedure. Procedure-specific risks often result from the anatomic and physiological changes created by the surgery. A common example of this is cholecystectomy, or removal of the gall bladder. Although the patient may be relieved of painful attacks of biliary colic, he or she may find that they can no longer tolerate highly fatty meals. The very purpose of bariatric surgery is to alter the gastrointestinal tract in such a way that caloric absorption falls well below the threshold needed to maintain one's weight. This benefit comes with the risk of developing clinically apparent nutritional deficiencies. In this chapter, we will look at the various nutritional problems that have been reported in bariatric surgery patients.